Oregon Ranks #7 in New AARP Scorecard on Long-Term Care Supports and Services

Portland, OR – AARP’s new Long-Term Services and Supports (LTSS) Scorecard finds that more than three years after the COVID-19 pandemic began, care provided in the United States for older adults and people with disabilities is painfully inadequate. The report finds that major gaps persist in every state, including Oregon, especially related to the long-term care workforce, nursing home safety and quality, and affordability and access.

According to the revamped and more expansive 2023 scorecard, Oregon ranks #7 in the nation in long-term care and supports for older Americans, a drop from #4 in 2020. The scorecard indicates some progress made in improved care options for older adults when it comes to providing support for family caregivers including paid family leave laws and paid sick day laws. However, the report shows there is still much more to be done to keep up with the rapidly changing needs of an aging population. Data indicates improvements needed in affordability and accessibility, choice of setting and provider, availability of adult day services, and greater safety and quality in care provided to residents in long-term care facilities.

“This is the first scorecard that incorporates data from the height of the pandemic and beyond. and it reinforces the need to strengthen long-term care for older adults and people with disabilies across the country, including in Oregon,” said Bandana Shrestha, AARP Oregon State Director. “All Oregonians deserve to age with choice and dignity and there are many opportunities to accelerate our efforts to meet their needs and those of their caregivers.”

Key findings from the report include: 

Family Caregiving

· Oregon continues to lead in efforts to support family caregivers including providing paid family leave, paid sick days and unemployment benefits for family caregivers.

Home and Community-Based Services

· Oregon experienced declines of 10% or more in adult day services since 2016, now ranking 50.

· Eleven states, including Oregon, had state policies that improve presumptive eligibility for Medicaid HCBS at the time of data collection, making it possible for people to go home to receive care after being in the hospital rather than having to be admitted to a nursing home while their eligibility for Medicaid payments is being determined.

Nursing Homes and Institutional Care

· A major workforce crisis exists in nursing home care. Across all states, wages for direct care workers are lower than wages for comparable occupations, with shortfalls ranging from $1.56 to $5.03 per hour. In Oregon, wages are $2.74 lower than other entry level jobs.

· Nationally, more than half of nursing staff in nursing homes leave their job within a year (53.9% turnover rate). In Oregon, the turnover rate is above the average, at 54.6%.

· Nationally, only 22% of nursing home residents live in a facility with a 5-star rating; about 33% of Oregon residents live in a 5-star facility. Gaps in workforce and equity result in persistent problems in care. For instance, about 10% of nursing home residents nationwide experienced a pressure sore, including more than 9% in Oregon. Pressure sores can be life-threatening as they can lead to bone or joint infections, cancer, and sepsis. Likewise, more than 10% of nursing home residents in Oregon are inappropriately receiving antipsychotic medication.

“COVID-19 tested our long-term care systems, and they failed. Now is the time to take the lessons we’ve learned to fix them, for the sake of saving lives,” said Susan Reinhard, Senior Vice President, AARP Public Policy Institute. “AARP’s LTSS Scorecard shows some progress and innovation, but there’s still a long way to go before we have systems that allow people to age well and independently for as long as possible and support the nation’s 48 million family caregivers. It’s also clear some emerging issues deserve more attention – from whether nursing homes are prepared to confront natural disasters, to whether they have plans in place to maintain and grow their workforces.”

Recommendations

Key recommendations from the report and AARP to strengthen support for long-term care and aging at home:

· Prioritizing saving time, money, and increasing support for the 48 million family caregivers, who are the backbone of the long-term care system, providing over $600 billion in unpaid care, such as with paid leave, tax credits, and other mechanisms to address health and financial needs. In Oregon, more than 470,000 family caregivers provide $8.7 billion of unpaid labor annually.

· Investing in all aspects of Home and Community-Based Care infrastructure, such as increasing support and training for home health aides and home visits, supporting the ability to access and use medical devices and equipment, and updating key Medicaid regulations and payment models.

· Bolstering the nursing home and in-home care workforce, with improved recruitment and training, increasing pay, and expanding the ability of trained nurses, aides, community health workers and other paraprofessionals to take on some aspects of care. States can choose to enact and enforce staffing and related care standards. 

· Expanding the use of innovative, effective models for nursing homes can improve both quality of care and quality of life, such as with smaller facilities and private rooms.

· Addressing inequities by investing to close the staggering gaps in access to quality care and facilities and staffing shortages.

· Building multisector plans for aging, coalitions and age-friendly health systems, and consider the wider needs to allow individuals to live independently in their homes and communities, such as having affordable and accessible housing and transportation, improved community design, and comprehensive emergency preparedness plans.

· Advancing innovation in cities, counties and states by supporting comprehensive state- and community-wide aging plans and piloting new approaches and programs, like Green House® Nursing Homes and presumptive eligibility, that can then be scaled.

· Ensuring every state in the nation has a sound emergency preparedness plan to support nursing home residents in times of crisis – including natural disaster.

The Scorecard includes a series of 50 indicators focused on 1) affordability and access; 2) choice of setting and provider; 3) safety and quality; 4) support for family caregivers; and 5) community integration, using data from a variety of publicly available sources, such as the Centers for Medicaid and Medicare Services, American Community Survey, and Bureau of Labor Statistics.

The LTSS Scorecard is funded by AARP Foundation with the support of The SCAN Foundation, The Commonwealth Fund, and The John A. Hartford Foundation and has been updated every three years since 2011.

State Rankings:

· Tier One: 1: Minnesota; 2: Washington state; 3: District of Columbia; 4: Massachusetts; 5: Colorado.

· Tier Two: 6: New York; 7: Oregon; 8: Hawaii; 9: Vermont; 10: New Jersey; 11: California; 12: Rhode Island; 13: Connecticut; 14: Maryland; 15: Wisconsin; 16: Maine.

· Tier Three: 17: Delaware; 18: Nebraska; 19: North Dakota; 20: New Mexico; 21: Pennsylvania; 22: Arizona; 23: Iowa; 24: New Hampshire; 25: Illinois; 26: Alaska; 27: Indiana; 28: Virginia; 29: Utah; 30: Kansas; 31: Michigan; 32: Ohio; 33: Montana; 34: Texas; 35: Idaho.

· Tier Four: 36: South Dakota; 37: Arkansas; 38: Missouri; 39: Georgia; 40: Wyoming; 41: North Carolina; 42: Kentucky; 43: Florida: 44: Nevada; 45: Louisiana; 46: Oklahoma.

· Tier Five: 47: Tennessee; 48: Mississippi; 49: South Carolina; 50: Alabama; 51: West Virginia.

To view the full Scorecard and state-by-state information visit www.ltsschoices.aarp.org.

For Media Inquiries about this News Release:
Contact: Stacy Larsen, slarsen@aarp.org, 503.260.5862